First-time mothers’ understanding and use of a pregnancy and parenting mobile application (The Baby Buddy app): a qualitative study using appreciative inquiry.

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Background Internationally, there is an increasing emphasis on early support of pregnant women to optimise the health and development of mothers and newborns. To increase intervention reach, digital and app-based interventions have been advocated. There are growing numbers of pregnancy healthcare apps with great variation in style, function, and objectives, but evidence about their impact on pregnancy wellbeing and behaviour-change following app interaction is lacking. This paper reports on the qualitative arm of the independent multicomponent study that explored the use and outcomes of first-time mothers using the Baby Buddy app: a pregnancy and parenting support app, available in the NHS App library and developed by a UK child health and wellbeing charity Best Beginnings. Objectives To understand when, why and how first-time mothers use the Baby Buddy app and the perceived benefits and challenges. Methods This paper reports on the qualitative arm of an independent, longitudinal mixed methods study. An Appreciative Inquiry (AI) qualitative approach was used with semi-structured interviews (n = 17) undertaken with new mothers, either by telephone or in a focus group setting. First-time mothers were recruited from three study sites from across the UK. In line with the AI approach, mothers were prompted to discuss ‘what worked well’ and ‘what could have been better’ regarding their interactions with the app during pregnancy. Thematic analysis was used to identify emergent themes and the findings are presented as themes with perceived benefits and challenges. Results The main benefit, or ‘what worked well’, for first-time mothers when using the app, was being able to access new information which they felt was reliable and easy to find. This led to a feeling of increased confidence in the information they had accessed thus supporting family and professional communication. The main challenge was the preference for face-to-face information with a healthcare professional, particularly around specific issues that they wished to discuss in depth. ‘What could have been improved’ included that there were some topics that some mothers would have preferred in more detail, but in other areas they felt well-informed and so did not feel a need to seek additional information via an app. Conclusions While this study included a small sample it elicited a rich dataset and insights on first time mothers app interactions. The findings suggest that easily accessible pregnancy information which is perceived as reliable can support first-time mothers in communicating with healthcare professionals. Face-to-face contact with professionals was preferred, particularly to discuss specific and personalized needs. Further research on maternal and professional digital support preferences post the COVID-19 global pandemic is recommended, and how they facilitate antenatal education and informed decision making. Especially as digital solutions remain a key element of pregnancy and early parenting care